A Comparative Study Of SPECT Myocardial Perfusion Imaging And Coronary CTA In Assisting Coronary Heart Disease Treatment Decision-making

ObjectiveTo investigate the value of one-day dobutamine stress/rest single photon emission computed tomography(SPECT)myocardial perfusion imaging in reducing coronary revascularization rates in coronary heart disease,which was compared with coronary computed tomography angiography(CCTA).Materials and MethodsAccording to the criteria of inclusion and exclusion,68 patients with coronary heart disease in our hospital from May 2019 to July 2021 due to chest tightness and chest pain were collected.All of them routinely underwent coronary computed tomography angiography(CCTA).Among them,34 patients underwent one-day dobutamine stress/rest SPECT myocardial perfusion imaging at the same time,and the therapy was selected based on SPECT results as the study group.The other 34 cases selected the therapy based on CCTA results as the control group.After the therapy was determined,the revascularization rate,symptom relief and single inpatient treatment cost of the two groups were compared.All patients were follow-up,the incidence of cardiovascular adverse events were compared between the two groups,the differences in the therapy recommended by SPECT and CCTA were compared and the reasons were analyzed.ResultsThere were no significant differences in age,gender and cardiovascular risk factors such as hypertension,hyperlipidemia,diabetes and smoking between the two groups(P>0.05).There was no significant difference in the degree of coronary artery lesions,the location of coronary artery lesions and the number of coronary artery lesions between the two groups(P>0.05).In the study group,one patient received revascularization therapy,and the revascularization rate was about 3%(1/34),thirty-three patients received drug therapy alone,and the rate of drug therapy alone was about 97%(33/34),all patients in the study group were relieved of clinical symptoms after corresponding treatment,and the symptom relief rate was 100%.In the control group,seventeen patients received revascularization therapy,and the revascularization rate was about 50%(17/34),seventeen patients received drug therapy alone,and the rate of drug therapy alone was about 50%(17/34),all patients in the control group were relieved of clinical symptoms after corresponding treatment,and the symptom relief rate was 100%.The revascularization rate of the study group was lower than that of the control group(χ2=19.342,P<0.05),and the cost of single inpatient treatment in the study group was reduced by about 31%compared with the control group.Follow up for 8-34 months(median 29 months),one patient in the control group had an cardiovascular adverse event(at 18 months of follow-up,the patient underwent unplanned revascularization)and the rate of cardiovascular adverse events in the control group was about 3%(1/34),no one in the study group had an cardiovascular adverse event and the rate of cardiovascular adverse events in the study group was 0(0/34).In the study group,there were 14 patients whose SPECT results were inconsistent with CCTA results.These 14 patients chose drug therapy alone based on SPECT results.ConclusionsOne-day dobutamine stress/rest SPECT myocardial perfusion imaging is safe and effective in assisting the treatment decision of coronary heart disease,which is beneficial to screen out patients with coronary heart disease who do not need revascularization therapy.Compared with CCTA,which is commonly used at present,it can reduce unnecessary invasive examination and interventional therapy,reduce total medical expenses and shorten hospitalization days.